- CDPHP (Albany, NY)
- …who share these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review ... of acute care experience is required as a Registered Nurse . + Minimum of two (2) years Utilization...to provide excellent customer service. + Demonstrated ability to review health care delivery against established criteria. + Must… more
- Albany Medical Center (Albany, NY)
- …stays, and documents findings based on Departmental standards.* While performing utilization review identifies areas for clinical documentation improvement and ... environment.* Basic knowledge of computer systems with skills applicable to utilization review process.* Excellent written and verbal communication skills.*… more
- Albany Medical Center (Albany, NY)
- …+ Basic knowledge of computer systems with skills applicable to utilization review process. + RN - Registered Nurse - State Licensure and/or Compact ... works proactively with the Quality Improvement Teams, patient care standards, and utilization management to coordinate the appropriate use of resources to achieve… more
- Catholic Health (Buffalo, NY)
- …with Weekend and Holiday Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager- Utilization Review , as an active member of the ... Care Management and interdisciplinary care team, provides comprehensive Utilization Review and discharge services to patients...Education, or BS in Health related field + Registered Nurse , licensed (unrestricted) in New York State + New… more
- Trinity Health (Troy, NY)
- …requirements for Utilization Management and works collaboratively with Utilization Management/Concurrent Review Nurse , physicians, staff and ... identification of possible concurrent denials, forwards information to the appropriate Utilization Management/Concurrent Review Nurse within identified… more
- Crouse Hospital (Syracuse, NY)
- …while maintaining the quality of care. + Demonstrates proficiency with standard Utilization Review processes. + Responsible for concurrent and continued stay ... outreach programs. Crouse's Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and client care as… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The RN Utilization Management Nurse Coordinator is responsible for both concurrent and ... retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for… more
- New York State Civil Service (Malone, NY)
- …of post-licensure clinical nursing experience of which one year was in utilization review and/or discharge planning.Substitution: a bachelor's degree in nursing ... NY HELP No Agency Corrections and Community Supervision, Department of Title Registered Nurse 3 - Utilization Per Diem Occupational Category Health Care,… more
- New York State Civil Service (Buffalo, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Greater Binghamton Health Center, P26033 Occupational Category ... Street City Buffalo State NY Zip Code 13904 Duties Description As a Utilization Review Coordinator, your duties will include:* Reviewing clinical records for… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
- Molina Healthcare (Yonkers, NY)
- …performing one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... For this position we are seeking a (RN) Registered Nurse who be licensed in the state they reside....are looking for a RN Manager to manage a utilization management team supporting 14 Marketplace plans. Home office… more
- Centene Corporation (New York, NY)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical review and assesses care related to mental health and substance abuse.… more
- Ellis Medicine (Schenectady, NY)
- Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily coordination of care across healthcare continuum with the healthcare team, ... responsible for preoperative, concurrent and retrospective reviews in accordance with the utilization management program. The UM RN ensures the appropriate level of… more
- WMCHealth (Valhalla, NY)
- …implementation or investigation of the procedures specified in the Quality Management, Utilization Review and Discharge Planning Program at Westchester Medical ... York State Department of Education, as a registered professional nurse . Training and Experience: three years of experience where...of which must have been in the area of utilization review , quality assurance, risk management or… more
- Mount Sinai Health System (New York, NY)
- …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge planning. The Assistant Director… more
- Molina Healthcare (Yonkers, NY)
- …in good standing Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... **Required Education** Any of the following: Completion of an accredited Registered Nurse (RN), Licensed Vocational Nurse (LVN) or Licensed Practical … more
- Centene Corporation (New York, NY)
- …criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care + ... + Assists with providing education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner- Cardiothoracic Stepdown Unit - Mount Sinai Hospital - Full Time - Split Shift** A nurse practitioner (NP) ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Nurse Practitioner-Outpatient Oncology - Multiple Myeloma - Mount Sinai Hospital - Full Time (4 10 hr shifts)- Day** A nurse ... nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and...the plan of care. + Performs a patient record review with the collaborating physician in a timely fashion… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients and ... Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or...of discharge planning process in collaboration with the clinical nurse initiates the discharge planning process on admission. *… more